MRS. MICHELLE BLACKSTON FNP
NPI 1194277152
Nurse Practitioner in Baltimore, MD

Q: What is Michelle Blackston's NPI number?

The NPI number for Michelle Blackston is 1194277152. It was assigned to this individual provider in the NPPES registry on October 25, 2016. The provider is also known as Michelle Pendora Johnson Fnp.

Q: What is Michelle Blackston's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since October 25, 2016PECOS EnrolledAccepts Medicare Assignment

1105 N POINT BLVD STE 321, BALTIMORE, MD 21224(410) 517-7060(443) 407-2942 Get Directions Write a Review

NPPES record last updated: January 26, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 26, 2023, Dec 5, 2020, Nov 15, 2018 and 2 more (5 updates tracked since 2016).

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About Mrs. Michelle Blackston Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MICHELLE BLACKSTON FNP (NPI 1194277152) is an individual nurse practitioner in Baltimore, Maryland, licensed in Maryland (R160398) and active in the NPI registry since October 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Baltimore, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1194277152

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMRS. MICHELLE BLACKSTONCredential: FNP

Location Address1105 N POINT BLVD STE 321Baltimore, MD 21224-3472

Mailing Address1105 N Point Blvd Ste 321Baltimore, MD 21224-3472 · (410) 517-7060 · Fax (443) 407-2942

Phone(410) 517-7060

Fax(443) 407-2942

Sole ProprietorYes

Medical School CMSOtherGraduated 2015

Enumeration DateOctober 25, 2016

Last NPPES UpdateJanuary 26, 20235 updates tracked since enumeration

NPPES CertifiedJanuary 26, 2023

✔ NPI 1194277152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MD · R160398

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X · License R160398 (MD)

1105 N POINT BLVD STE 321, Baltimore, MD 21224

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Other Names 1

Former Name (1)Michelle Pendora Johnson Fnp

Secondary Practice Location 1

Location 17000 Harford RdBaltimore, MD 21234-7704 · Phone (443) 438-5612

Other Identifiers 1

Medicaid783304100MD

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Michelle Blackston Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991089237

PECOS Enrollment IDI20170303001657

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

206 services61 patients

Psychiatric diagnostic evaluation with medical services 90792

A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.

21 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21224 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.08 typical visit price

range $60.73 – $183.44

Typical copayment $23.52 (range $15.18 – $45.86)

Most-billed visit code 99203

Established Patient

$106.59 typical visit price

range $19.60 – $149.17

Typical copayment $26.64 (range $4.90 – $37.29)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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